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Diseases and Conditions
Lichen sclerosus
From MayoClinic.com
Special to CNN.com

Introduction

Lichen sclerosus (LI-kun skluh-RO-sus) is a rare condition that creates patchy, white skin that's thinner than normal. Lichen sclerosus may affect skin on any part of your body, but most often involves skin of the vulva, foreskin of the penis or skin around the anus.

Anyone can get lichen sclerosus, but postmenopausal women and prepubertal children are at highest risk. Left untreated, lichen sclerosus may increase your risk of skin cancer and lead to other complications.

Treatment of lichen sclerosus may involve medications.

Signs and symptoms

Lichen sclerosus can affect the skin on any part of your body. Itching (pruritus) and discomfort are the most common symptoms, but symptoms are often absent, regardless of where the condition appears. Discomfort is generally greater if lichen sclerosus appears on or around your genital or anal areas.

Additional signs and symptoms may include:

  • Smooth white spots on your skin that may grow into blotchy, wrinkled patches
  • Tenderness of the affected areas of your skin
  • Easy bruising or tearing
  • In severe cases, bleeding, blistering or ulcerated lesions

Causes

The exact cause isn't clear. However, the condition may be related to a lack of sex hormones in the affected skin or to an overactive immune system. Previous skin damage at a particular site on your skin may increase the likelihood of lichen sclerosus at that location. Although lichen sclerosus may involve skin around your genitals, it isn't contagious and cannot spread through sexual intercourse.

Lichen sclerosus occurs most often in postmenopausal women, but it also occurs in men and children. In women, lichen sclerosus usually involves the vulva. In boys and men, uncircumcised males are most at risk, because the condition generally affects the foreskin. In children, the signs and symptoms may improve at puberty.

Screening and diagnosis

Your doctor may diagnose lichen sclerosus based on:

  • A physical examination
  • Removal of a small piece of affected tissue (biopsy) for examination under a microscope

Complications

Persistent lichen sclerosus in one location increases your risk of skin cancer. For this reason, make sure that you have follow-up examinations every six to 12 months.

Other potential complications:

  • For women, the uncomfortable itching and scarring that accompanies severe lichen sclerosus may narrow the vaginal opening and affect the ability or desire to have sexual intercourse. In some cases, the blistering may create extremely sensitive skin to the point that any pressure on the area is unbearable.
  • For men, lichen sclerosus can in rare cases involve the foreskin. The tightening and thinning of the foreskin may create complications during erections or when urinating.

Treatment

You may not need treatment for lichen sclerosus, especially if it occurs away from your genital areas. In fact, many cases disappear on their own.

For adults and children with a more advanced condition or with lichen sclerosus on or around the genitals or anus, doctors most commonly prescribe corticosteroid ointments or creams, which are usually quite effective.

Other treatments for lichen sclerosus that your doctor may suggest include:

  • Ultraviolet light treatment, for nongenital areas
  • Immune-modulating medications
  • Prescription sex hormones

Treatments cause your skin to assume a more normal appearance and decrease its tendency for further thinning.

For men with lichen sclerosus on the foreskin, removal of the foreskin (circumcision) is a common treatment.

  • Lichen nitidus
  • May 09, 2006

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